Medical abortion is a procedure that uses various medications to end a pregnancy. A medical abortion is started either in a doctor’s office or at home with visits to your health care provider.

Medical abortion doesn’t require anaesthesia or surgery, but it should be done early in pregnancy. Unlike a surgical procedure, a medical abortion usually is done without entering the uterus.

During the procedure
Medical abortion can be done using the following medications:
Oral mifepristone and oral misoprostol. This is the most common type of medical abortion, likely due to the ease of oral rather than vaginal dosing. These medications must be taken within seven weeks of the first day of your last period. Mifepristone (mif-uh-PRIS-tone) — also known as RU-486 — blocks the action of the hormone progesterone, causing the lining of the uterus to thin and preventing the embryo from staying implanted and growing.

Misoprostol (my-so-PROS-tol) causes the uterus to contract and expel the embryo through the vagina. If you choose this type of medical abortion, you must visit your health care provider twice to take the medications and then afterward to make sure the abortion is complete.

Methotrexate injection and vaginal misoprostol. This type of medical abortion must be done within seven weeks of the first day of your last period. Methotrexate is given as a shot by your health care provider and the misoprostol is later used at home. You must visit your health care provider within a week of getting a methotrexate shot for an ultrasound to confirm if the abortion is complete. If the pregnancy continues, another dose of misoprostol will be given.

Vaginal misoprostol alone. This method may be used over a broader range of gestational ages, but requires scheduling multiple doses of the medication. Vaginal misoprostol alone can be effective in promoting the completion of a miscarriage — a spontaneous abortion where the embryo has died.

The medications used in a medical abortion cause vaginal bleeding and abdominal cramping. They may also cause:
Nausea, Vomiting, Fever, Chills, Diarrhea, Headache.

You may be given medications to manage pain during and after the medical abortion. You may also be given antibiotics.
Your health care provider will explain how much pain and bleeding to expect, depending on the number of weeks of your pregnancy. You might not be able to go about your normal daily routine during this time, but it’s unlikely you’ll need bed rest. Make sure you have plenty of absorbent sanitary pads.

If you have a medical abortion in a health care provider’s office or clinic, you’ll have a pelvic exam before you’re given additional doses of misoprostol to see if the foetus has been expelled. The frequency and strength of your uterine contractions also will be monitored. While the most discomfort may last one to two hours, spotting before and bleeding after could last two weeks.